Kerry Carmody
Administrator, Providence Holy Cross Medical Center

Interview by Leon Worden
Signal Multimedia Editor

Sunday, July 3, 2005
(Television interview conducted June 23, 2005)

Kerry Carmody     "Newsmaker of the Week" is presented by the SCV Press Club and Comcast, and hosted by Signal Multimedia Editor Leon Worden. The program premieres every Wednesday at 9:30 p.m. on SCVTV Channel 20, repeating Sundays at 8:30 a.m.
    This week's newsmaker is Kerry Carmody, chief adminstrator of Providence Holy Cross Medical Center in Mission Hills. Questions are paraphrased and some answers may be abbreviated for length.

Signal: Providence has had its eye on Henry Mayo Newhall Memorial Hospital for quite some time. What makes Newhall Memorial a good takeover target?

Carmody: First of all, what we're looking at is health care in the Santa Clarita Valley, and we have had informal talks with Henry Mayo in the past.
    What we were looking at doing, and what we have talked about with them, is — Holy Cross is undertaking a major expansion program, a $116-million expansion to the campus, 11 miles away in Mission Hills. And 20 percent of our patients in the hospital are from the Santa Clarita Valley. Some services, such as open-heart surgery, 41 percent of our patients come — this year about 80 patients from Santa Clarita will have open-heart surgery.
    We are looking to the future and we're saying that the health care needs of the Santa Clarita now and in the future — can they best be met singly, or together? I think the discussions were simply that: Are there opportunities to work together to meet the needs of a very quickly growing community? As you know, (there will be) 30 percent growth in the next 10 years.

Signal: Whether Providence buys out Newhall Memorial or builds a second hospital, can the Santa Clarita Valley sustain two hospitals?

Carmody: I think if you're looking 30 years — 10 years, 15 years down the line is where you need to look at where this community is going. My wife Kristie and I have lived here for 16 years. This is a totally different community from the standpoint of growth than it was 16 years ago. It's a great place to live. Everybody wants to live here.
    So as that grows, we're looking at opportunities to meet those needs of the patients we serve now, their families, but also the patients who will be here in the future as this area grows (by) another 80,000 people in, let's say, the next 10 years.
    So our first step is totally on an outpatient basis, which is our new health center at the corner of McBean (Parkway) and Valencia Boulevard, where we're bringing outpatient services to the community. Many of those patients then don't have to travel outside the community.
    Directly to your question on, can Santa Clarita can sustain two hospitals? I don't really know, but what we do know, and what the data show us, is that five to six out of 10 hospital admissions in the valley are outside the valley. So people are leaving the valley about 50 percent of the time to have their health care.
    Many of them are Kaiser patients; those Kaiser patients are already leaving the valley. Many of them are either coming to Holy Cross — which is the third-biggest provider of health care in the Santa Clarita Valley — or they're going to Northridge, UCLA or other tertiary hospitals. So it's an event that's already happening.
    There's no one hospital or even two hospitals, probably, that could sustain the volume that's happening now, plus 10 (or) 15 years from now.

Signal: Why, today, would someone in the Santa Clarita Valley opt to go to Holy Cross instead of Newhall Memorial?

Carmody: Patients are driven by health plans' physicians. Holy Cross and Henry Mayo actually have 150 physicians on the medical staff who work at both hospitals. So it's really a close working relationship. We're both trauma centers.
    But there are some services — it may be their physician, or they've got to have a relationship from when they lived in the San Fernando Valley, or they have an OB physician who delivers at Holy Cross; there may be services such as open-heart surgery or cardiac services, cath lab services, that aren't provided currently in the Santa Clarita Valley that they travel down the 14 (Freeway) or (Interstate) 5 to Holy Cross — which is why we're expanding our campus significantly.
    We currently operate at 100-percent capacity every day. We're a 254-bed hospital. Everyone's aware, Henry Mayo is also very busy. So when we say, Can we sustain it? We're already doing that. We are putting a $116-million expansion to Holy Cross of which 25 to 30 percent of those beds are really allocated for Santa Clarita Valley residents, knowing the growth that is happening and the number of patients who currently travel across the hill.

Signal: Newhall Memorial has an enormous service area, something like 650 square miles. If you're both trauma centers, do you also have a defined service territory?

Carmody: That's a great question. We actually are the only private trauma hospital of the 11 that has no defined area — which means we service the largest area of any of the private trauma hospitals.
    We are the trauma center for the Antelope Valley. What most people don't know is that if you travel beyond Agua Dulce on the 14 (Freeway), and should something happen on Pearblossom Highway and you're in an auto accident, you will be airlifted to Holy Cross.
    This year we will see 350 trauma patients from the Antelope Valley, from Agua Dulce, out all the way past Lancaster. We've actually seen patients as far away as Bishop, Calif.
    Our mission has been to treat those who are in need, so as long as we can do that, we will see patients from all areas.
    Another good example of that (was) the Metrolink disaster in January. It was actually in Glendale. Holy Cross saw nine patients from that disaster, three of them trauma patients. Why? Because even as busy as we were that day, we were wide open. We accepted every patient who came into our hospital. And that is one reason why, this year, Holy Cross will see over 1,400 trauma patients.
    It's a service that we're dedicated to, as is Henry Mayo. We have an open catchment area, and we're the only hospital currently that can say that.

Signal: Newhall Memorial has been our community hospital for 30 years. It's run by a community-based nonprofit board with no parent company. You live here, and other Providence employees live here, and you're expanding Providence's footprint in our valley, but some people still think of Providence an outsider — a San Fernando Valley group that's coming in and trying to push out Newhall Memorial. How do you respond?

Carmody: I can understand that, if you don't have all the information, and I can certainly feel that from them.
    First of all, Holy Cross is probably one of the largest employers of Santa Clarita residents; we have 350-plus employees who live and raise their families and shop and attend baseball games and so forth here in the Santa Clarita Valley. My wife and I have lived here for 16 years, as an example. Twenty-five percent of our nurses at Holy Cross live in the Santa Clarita Valley. So there's a long connection there.
    When Holy Cross was first built 44 years ago, it was the largest medical center from Burbank to Bakersfield. It has a long, 44-year history of serving the population in the Santa Clarita Valley. And as the population has grown, those services have grown, as well, which is the reason why we're currently expanding our outpatient services here.
    Holy Cross is a community-based hospital with a community board — no different than Henry Mayo in this valley. We have board members from the Santa Clarita Valley, we have board members from the San Fernando Valley, we have a foundation; very similar. The models are exactly the same.
    It's just that we happen to be part of a large system, which gives us a number of things. It gives our employees a defined benefit plan, which is outstanding. We have 32,000 employees in the total Sisters of Providence Healthcare System, which has a terrific benefit plan, which also has an AA-rated non-for-profit bond rating, which allows us access to capital for expansion and so forth. So it's a very stable company, a very conservative company, but a company that's committed to the mission.

Signal: Providence is based in Washington, right?

Carmody: The corporate office for the Sisters of Providence Health System is in Seattle. Each of the hospitals in the system has its own community board, and the board is responsible for the governance, for quality, for actually credentialing the medical staff, for strategic planning for that facility. So we've worked very closely with the community members who are part of our community board, along with our medical staff.
    We have 555 medical staff physicians who work at Holy Cross; 150 of those actually work at Henry Mayo, so there's a natural overlap.

Signal: You're in charge of the Holy Cross facility and also of Providence's dealings here in the Santa Clarita Valley?

Carmody: Yes. The project that we're hoping to complete this summer — the reason I say "hoping to complete," the rains really delayed the construction, but as people can see, the skin's gone on the building; we're very excited about it. It's an 80,000-square-foot building with a number of services including physicians' offices. But that Holy Cross Health Center will be ultimately my responsibility as well, which I'm very excited about.

Signal: We're talking about the facility at McBean and Valencia?

Carmody: Correct.

Signal: According to one of your press releases, you're looking to open a cancer center, a surgery center and an imaging center there. Newhall Memorial has an imaging center; are these services that don't exist in this valley or are lacking?

Carmody: There are some that complimentary. If its a MRI, it's going to be an MRI at that facility. This valley can support a lot more imaging, from the standpoint of the health care needs of the community.
    We will have a CT-PET (positron emission tomography) scanner, which will be the only one. People say, "What's that?" It's basically a diagnostic tool to diagnose cancer. And it's part of our overall cancer program where we will have a linear accelerator and a very comprehensive cancer program along with a medical oncologist in the building.
    To give you an example, my sister-in-law is currently undergoing radiation treatment for breast cancer. Breast cancer, depending on the type, obviously, it may be different, but it involves up to 30 different radiation treatments for that woman. We see many — 24 percent of our current cancer patients who we see at our cancer center, our radiation center at Holy Cross, are traveling every day over the hill. This is an opportunity to stay in the community and have those same services, outstanding technology.
    Our medical director, Dr. Nancy Ellerbroek, is a resident of Santa Clarita. She's been at Holy Cross since 1993. She will be operating both facilities. She's got outstanding credentials. She's a wonderful lady and she's excited about being here, as well.

Signal: Looking into your crystal ball, when do you see Providence operating a full-blown hospital here in the Santa Clarita Valley?

Carmody: I really don't have any answer for that because I can't see that far in advance. All I will say is that as a rule of thumb, as we've looked at it, is for every 1,000 population, you look at two in-patient hospital beds.
    So I don't know what the future brings. I'm focusing on Holy Cross and our outpatient center and the success of that center. But if you look five, 10, 15, 20 years from now, if we grow 100,000 in population, that's essentially 200 additional beds that will be needed, either in the valley or over the hill — which has been our strategy since the beginning at Holy Cross is to — that $116 million building, will have 136 new patient beds in it, along with the neonatal intensive care unit and additional operating rooms and so forth.
    So we're building for the future, and our future sees tremendous growth in Santa Clarita as well as in the north San Fernando Valley; that's growing very quickly, as well.

Signal: You mentioned neonatal care. We've got a very young population and a very old population in the SCV. Do you see an opportunity for Providence to fill those niches with a pediatric wing or a geriatric unit?

Carmody: Not so much geriatric anymore, because those are usually handled in acute-care settings, and those patients are able to go to other settings to rehab and so forth. But we have evaluated the need for a neonatal intensive care unit.
    Obviously with our growth — about 3,000 babies will be born at Holy Cross this year. And about 15 percent of those ... will be from the Santa Clarita Valley. We will be putting a 12-bed neonatal intensive care unit into our new expansion.
    Again, that's for our high-risk babies who may have to go to Children's Hospital now to be treated, or to Northridge. With the tremendous growth in both the north San Fernando Valley and certainly the Santa Clarita Valley, we see a need for that service.

Signal: But not necessarily a facility in the SCV anytime soon?

Carmody: Not strictly for that, no. It's a service that could be provided in either location, obviously.

Signal: Holy Cross — what exactly is the relationship with the Catholic Church?

Carmody: Well, we are a Catholic facility, which means we abide by the Catholic and religious directives. Our parent company and our local hospitals keep a relationship with the bishop, to let them know how we are doing, but it's totally cellphoned from the Sisters of Providence, a not-for-profit entity.
    Our mission statement has been the same for 152 years, and that is in the healing ministry of Jesus, meeting the health care needs of those we serve, with a special focus on the poor and vulnerable. That has always been our mission, and that's something we're very proud of.
    We do a lot of outreach services in the Santa Clarita Valley, outside of acute health care, which we believe demonstrate that commitment to community and outreach services. Anywhere from our parish nurse partnership, where we work with the local parishes, Catholic and non-Catholic — we have a bloodmobile that works with businesses, with the schools — Valencia High School, College of the Canyons and many others — and we also have a school nurse program, where we provide school nurses to parochial schools or private schools that don't have funding for their own school nurses, where we can look at the health needs of the youngsters in those primary grades.

Signal: Do you still have nuns who are nurses?

Carmody: There are some, but not as many as (there) used to be. We don't currently have nuns who are RNs at Holy Cross.

Signal: You mentioned "poor and vulnerable." At Newhall Memorial, they have to admit anybody into ER, regardless of ability to pay. Is it the same for Holy Cross?

Carmody: Exactly.

Signal: Are there medical procedures that you won't perform on religious grounds?

Carmody: Well, I think — we do not perform abortions in our acute care hospitals or any of our facilities, which is not unlike many other facilities, because those are really outpatient procedures now. There are lots of opportunities locally, whether it be in Santa Clarita or the San Fernando Valley, for a woman or a family who are in need of those services to have those services.

Signal: You don't have any union representation at Holy Cross, do you?

Carmody: No. Holy Cross is currently a non-union hospital. There was an attempt by a union to organize the employees about 2-1/2 years ago, and it was unsuccessful.
    We work very hard with our relationship with our employees, our medical staff, our management staff, as well as the leadership within nursing and so forth. In fact, Fortune magazine has approached the Sisters of Providence, our whole system, and asked us to participate in a survey to see if we will qualify as one of the top-100 employers in the United States. We're really honored about that; the survey is going on now, so we'll see how that comes out. But we felt it was quite an honor to be asked.
    Our employee satisfaction scores, which every hospital looks at, we're very proud of. We're in the top 5 percent nationally on the relationship with our employees, how happy they are to work at our facility. We have the lowest nurse vacancy rate of any hospital in Los Angeles County. We're extremely pleased with that. And we were just named, from the standpoint of quality of services — last year, 2004, the National Society of Oncology Nursing, which is a national organization for nurses who specialize in cancer care, named Providence Holy Cross as the No. 1 employer in the United States for oncology nursing.
    So our focus is on quality and nursing care, and we're currently undergoing what's called a magnet process with nurse magnet, to become only the second hospital in L.A. County — Cedars being currently the only hospital — to reach what's called a nurse magnet status. That's where a national association of nursing comes in and inspects your hospital. It takes days, years to prepare for. We hope to be one of the 2 percent of the hospitals in the country that are known for outstanding nursing.
    To me — I'm not a nurse; I actually started in a laboratory 32 years ago — but nursing and clinical care are what really drive a hospital's success.

Signal: Newhall Memorial uses a registry; does Holy Cross?

Carmody: We do ... use registry occasionally, but we actually use it very little.
    To give you an example, we currently have no nursing openings in our emergency room. Most of our floors are fully staffed. We do have some — what are called traveling nurses; we currently have 20 traveling nurses, who will come and work for your hospital for 13 weeks or 26 weeks and (can) convert to full time. So we get many nurses from outside California with a California license who want to come to California when the weather's good and try it out, see if they like it. But we use a significantly (smaller) number of hours for registry and traveling nurses, because we have a low vacancy rate.
    Now, we can always be better — everybody could — but there's a statewide shortage of nursing, which is why we, along with Henry Mayo, are very active in the nursing collaborative with College of the Canyons. We've worked very closely to develop that program, and in fact, Holy Cross was one the initial activators of that program and put a significant amount of grant money into starting that.
    College of the Canyons, hands down, has the very best nursing program locally, and we are one of the training sites for them. There is such a shortage of nurses, I encourage everyone ... to consider nursing as a career and to go to College of the Canyons. Great program.

Signal: Newhall Memorial went into and came out of bankruptcy in recent years. Providence was a major creditor. Where do you stand financially now with them? Are they in your good graces?

Carmody: They always were. I think that the deal that was worked out was fair for all parties. I'm not the (chief financial officer) of our organization, but everything is — if it's not already paid off, it's very close to. It has worked out very well for everyone. I think they're doing well, and we're glad.

Signal: There was talk at that time of the possibility of Providence coming in as an operator. What happened?

Carmody: We've spoken with the hospital — this will be three times, totally, and they chose, which is their prerogative, to take care of their operations internally, and they've been successful at it.

Signal: What would be the deciding factor today? Who makes the decision? How would it work for Providence and Newhall Memorial to come together?

Carmody: I think the opportunity presented itself when Holy Cross decided to invest $116 million in our campus expansion. Knowing that a large number of those dollars are to also serve the Santa Clarita population, which is growing at such a rapid rate, that there was discussion about what amount of that capital could we then work with Henry Mayo to then invest in the local community.
    I think that was the discussion. Where it is now, I couldn't tell you. It's up the local governing body of the local hospital, and I'm sure they'll make the right decision that's for them.
    We wanted to make sure we explored every option before our plans are complete and go to the state OSHPD (Office of Statewide Health Planning and Development) agency. Because once they go to OSHPD, (the plans are) firm, and we're moving ahead with the full-blown $116 million project.

Signal: Newhall Memorial is expanding its emergency room; are you expanding yours?

Carmody: Actually we're expanding our emergency room, great question. We'll see 46,000 emergency room patients this year at Holy Cross. Our expansion in our emergency room, we've completed Phase I and Phase II. It's a five-phase program. So we're about 40 percent done.
    We're adding 6,000 square feet, another 18 beds, (and) imaging. We put in a new MRI; a second cath lab is going in. It is a totally foundation-funded project. It's a $7.5 million project, and we have raised, as an organization, almost $7 million now. The construction is well on its way. We expect it to be completed in 22 months. Because we see the growth in Santa Clarita but certainly in the San Fernando Valley; we actually have patients traveling from the Antelope Valley to our emergency room. Every hospital is in that same situation, and very few (have) the ability where they can actually expand their services.
    I think locally, we're blessed to have two hospitals that have active foundations that are supported by their communities, and both are moving very quickly to meet the needs.

Signal: What's the average time for an emergency room visit at Holy Cross, from in the door to out the door?

Carmody: We measure everything. I'm sure everybody does. It depends on the day, but we measure time to see physician, and time in and time out, and we average under two hours.
    Now, in peak, it may be longer than that. But I'll tell you one thing we do measure — and it's measured nationally by the joint commission, which is the agency — and that is from the time you hit the emergency room to the time you have a heart (catheter) put in, if you're having a heart attack. Holy Cross is currently in the top 25 percent of the country. So that means, as soon as a patient enters the emergency room, they're having their heart cath done in under 90 minutes, 83 percent of the time. That's something that we're extremely proud of, and only 25 percent of the hospitals in the country are at that rate. Which means, if you've got a critical emergency and are having a heart attack, we're able to treat it.
    We will perform 2,000 heart caths this year. We'll do 180 open-heart surgeries at Holy Cross. Our second cath lab will be completed in October of this year. Why is that important? Again, anyone traveling the freeways, or if you need open heart surgery or so forth, we're 11 miles away; there's a good chance that you're going to need those services. We want to be able to provide those very best services.

Signal: What are Providence's plans to get involved in the community?

Carmody: We are already active up here in many areas, whether it be the Arthritis Foundation Walk; we are also a co-sponsor of the upcoming Leukemia/Lymphoma Walk. We'll be a sponsor of the upcoming (Santa Clarita) Marathon. So we're active here. I live here, so I want to be as active as possible...
    We're committed to meeting the health care needs, and it's really about the community growth and meeting those. There's been a lot of discussion in your paper and in the news about infrastructure growth. The discussion is around roads, it's around schools, it's around the new auto dealerships that are coming. It's around the new stores that we'd like to have in town. I have not heard that good discussion about, where's the infrastructure for health care.
    What we're doing is expanding our presence in the valley physically, now that we have our new 80,000-square-foot building, to meet that infrastructure need for health care — not just today, but five, 10, 15 years in the future.

    See this interview in its entirety today at 8:30 a.m., and watch for another "Newsmaker of the Week" on Wednesday at 9:30 p.m. on SCVTV Channel 20, available to Comcast and Time Warner Cable subscribers throughout the Santa Clarita Valley.

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